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Case Reports
. 2010 Feb 3:2010:652398.
doi: 10.4061/2010/652398.

Primary leiomyosarcoma of the kidney

Kusuma Venkatesh  1 , Monika Lamba Saini, S R Niveditha, Chaithra Krishnagiri, Sudarshan Babu
Affiliations
Case Reports

Primary leiomyosarcoma of the kidney

Kusuma Venkatesh et al. Patholog Res Int. .

Abstract

Primary leiomyosarcoma of the kidney is a rare tumor with an aggressive behaviour. A 55-year-old woman presented with a left sided abdominal mass in our outpatient department. Radiologic investigations revealed the mass to be renal in origin with colonic adhesions for which radical nephrectomy and hemicolectomy were done. The tumor completely appeared to replace the left kidney and had a whorled character focally on cut section. Microscopically, spindle cells having malignant features with cigar shaped nuclei were seen. The smooth muscle origin of the cells was confirmed by immunohistochemical positivity for smooth muscle actin. Sarcomatoid variant of the renal cell carcinoma was ruled out as the tumor was negative for cytokeratin. Tumors with spindle cell morphology in the kidney should not always be taken for a sarcomatoid variant of renal cell carcinoma and should be investigated thoroughly.

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Figures

Figure 1
Figure 1
Tumor showing areas of necrosis, haemorrhage with a small portion of dilated appearing kidney.
Figure 2
Figure 2
(a) Spindle cells arranged in interlacing bundles [10×]. (b) Cells with pleomorphic nuclei with blunt ends & eosinophilic cytoplasm [40×].
Figure 3
Figure 3
(a) Positive immunostaining for smooth muscle actin [40×]. (b) Cytokeratin negativity [40×].
See this image and copyright information in PMC

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